This will be an exciting year for the AAWR. We have several new activities this year for ourAAWR-sponsored sessions at national meetings, with plans to include a women’s caucus at the annual meeting of the ACR,and to sponsora meet and greet session at the annual AUR meeting. This year’s first quarter Focus has several articles that I hope you will find interesting. One is on gender bias in the radiology resident selection process. This issue will also include updates from RSNA 2015.

Please contact me if you are interested in serving on a committee or helping in any capacity. It takes a group of dedicated people to run a successful organization.

I am looking forward to working with all of you this year.

Best regards,

Susan

“The most difficult thing is the decision to act, the rest is merely tenacity’

AAWR Luncheon at ARRS 2015
Elizabeth K. Arleo, MD

Twenty AAWR members gathered for lunch in Toronto’s Metro Convention Center on Thursday, April 23, 2015, 12-1pm, for the annual AAWR luncheon at ARRS. Dr. Lynn Fordham, previously president of the AAWR, presided. Several other past AAWR presidents attended as well, including Dr. Katarzyna Macura[and any others]. A lovely buffet including soup, pasta salad, sandwiches, iced tea, coffee, fruit “shards,” and delectable cookies was enjoyed by all.

First, Dr. Neda Sedora-Roman, a 3rd year radiology resident at Beth Israel Deaconess in Boston, was awarded the AAWR ARRS Member-in-Training Award for 2015 for her abstract, “Breast MRI: Us BIRADS 4A, 4B, 4C helpful in interpretation?” Then, the panel discussion, “Future women leaders in radiology: how to climb the ladder and overcome challenges,” began. The panelists attempting to address this difficult topic included: Dr. Kathleen Fink, a neuroradiologist at the University of Washington; Dr. Elizabeth K. Arleo, a breast/body imager from NY-Presbyterian Hospital / Weill Cornell; Dr. Ashley Simonak, a 4th-year resident at University of South Carolina; and Dr. Jennifer Favinger, chief radiology resident at University of Washington. Several themes recurred, including the importance of: a supportive partner and nanny; a positive work environment, where there is an emphasis on being a team player and helping colleagues; considering carefully when to reveal pregnancy during a job search; saying yes and no according to whether doing something, or not, furthers individual professional and/or personal goals; and multiple reminders to “take care of yourself!”

The conversation continued after the panel hour ended, with members and attendees continuing to talk and network until the next scientific session began. We look forward to seeing you at future AAWR events, which occur at nearly every major national and international radiology meeting – for details, please visit the website: www.aawr.org. If you have friends who are considering AAWR membership, then please bring them along!

Working 2016 - Married with Children Edition.
Beyond Studs Turkel and Why Leaning In is Not Enough.
Etta Pisano, MD

I’ve been on sabbatical since October 1st, 2014. Before that, I was Dean of the College of Medicine and Vice President for Medical Affairs at the Medical University of South Carolina in Charleston. Before that, I was Vice Dean for Academic Affairs and Kenan Professor of Radiology and Biomedical Engineering at the University of North Carolina, and led the Translational Clinical Sciences Institute and the Biomedical Research Imaging Center there. Before that, I led the Breast Imaging division in the Department of Radiology at UNC and before that at Beth Israel Hospital in Boston. I’ve been President of the Association of University Radiologists and the AAWR. I chaired the Breast Imaging Committee of ACRIN for its first decade and led DMIST, the study that showed that digital mammography was superior to film for women with dense breasts. I’ve founded a medical imaging company, NextRay, based on a patent I received with some colleagues to develop a new way to use x-rays, diffraction enhanced imaging. I’ve had a varied and exciting career. I’ve also been married to the same man, Jan Kylstra, an ophthalmologist who I met at Dartmouth as an undergrad, for almost 34 years. We have four kids – two daughters and two sons, ages 29, 25, 24 and 20. Our two oldest are married. The two youngest are still in school. We are now empty nesters and searching for what’s next in our lives.

People ask me all the time how I do what I do. I always feel sort of surprised by the question since there are so many people around all of us managing so well, many with fewer resources than my husband and I have had. And of course we have been lucky. Our kids and we have been healthy overall and our problems have been the more manageable sort. Still people ask all the time, which led me to ponder – what more is there to say about this? What can I possibly add to this conversation?

In early 2001, at the invitation of Stan Baum, I wrote a paper on Time Management for Academic Radiology (1). There I gave my top tips on how to make things happen more efficiently. Those tips were short and sweet and included delegating, prioritizing, strategizing and avoiding guilt. These are important tips – suitable for a short article on the topic – but really just the beginning of what there is to say. This is a topic which is apparently of burning interest to lots of women and men who are working on having comfortable happy lives, with both career and family.

So, after watching with interest (and frankly incredulity) as Sheryl Sandburg told all of us to “Lean In”, and rereading Studs Turkel’s seminal work on “Working”, I decided that there is a need for some practical advice from the real experts on this topic – those who have had careers and raised children while maintaining their marriages and who consider themselves happy. What have they done to make it work? What tips can they share with others? I decided to write a book and to recruit a young coauthor, Katherine Buse, someone just starting on her own journey, because I thought her perspective was important in sharing information with people her age. Together we interviewed many couples across the socioeconomic spectrum to hear what they had to say about how they managed their own choices, how they made career and life work in a way that allowed them to have happy fulfilled lives. Much as Studs Turkel interviewed many working men and women in writing “Working”, we plan to convert our interviews into a “Modern Family” version on the same topic. We expanded his focus from just “Working”, to “Working: Married with Children Edition”.

We have interviewed a range of people across a range of occupations. Yes, there are doctors and scientists included, but there are also artists and teachers and nurses and entrepreneurs and writers and all sorts of people. We believe the stories they told us contain lots of information that is applicable across a spectrum of situations. The common themes are teamwork, optimism and a can-do spirit. Our couples all believe in each other and themselves, are supported by a larger community, and work hard on finding solutions that fit their situation when things go wrong. The interviews were fascinating to conduct and to read. These people have a lot to teach all of us. We believe that after some editing, the interviews will make a great book some day soon.

This project is still a work in progress as I write this essay. We are seeking more interviewees to help us round out the sample of people who we have interviewed. We would like to include more same sex and nonwhite couples who fit our profile – two career couples with longstanding intact relationships and children who have left the nest. If you fit that profile or can suggest others who do, please email me with a brief description of your nominees and their contact information at etpisano@gmail.com and I will be in touch to schedule an interview!

If all goes as planned, Katherine and I will be finishing the book by January 2016. Stay tuned!

The Right Mix

Consolidations and mergers are becoming a reality for many practices. What changes can you expect, and how can you make the process smoother for everyone involved?

April 2015

This isn’t news to you: health care is changing. Reimbursements are decreasing, value is king, and competition is high.

In order to adapt, some practices are choosing to ally themselves with other practices or hospitals through mergers, consolidations, or acquisitions. Changing the size of your group can have implications for everyone — leadership, employees, other physician colleagues, and patients. With a growing number of practices opting to join together, radiologists share the issues they’ve encountered and the strategies they’ve developed to make change easier for everyone involved.

Connection Creation

Unsurprisingly, uniting with hospitals or other organizations can often inject new life into radiology groups. Radiological Associates of Sacramento (RAS) was recently acquired by the health system Sutter Health. Jonathan Breslau, MD, FACR, former president of RAS, says that he’s found the acquisition process to be positive for his practice, in which all of the radiologists transitioned to employment within Sutter Medical Group. One of the best changes has been closer collaboration with his clinicians. Because the radiologists are now working in the same medical group as their referring physicians, they’re better able to understand some of the issues their clinicians face. "We’re seeing some of the challenges they face in their clinics, such as how they deal with their patients and their resources. I’ve been able to talk with them and get a sense of the issues that they’re facing with compensation too. It’s given me a better perspective of how the imaging department can deliver value to them," he adds.

Paper Pushing

Despite these positives, acquisitions and mergers can be challenging, especially if you are acquiring more people or becoming part of a larger system. You may have to face increased bureaucracy. Everything becomes more complicated and time consuming when you’re part of a larger group, notes Breslau. "It’s extremely frustrating at first," he says. "It takes months to execute on certain initiatives because there are many stakeholders who have to be brought into the decision-making and implementation." According to Breslau, that bureaucracy also makes it harder for the department to take risks with certain innovations it might want to try.

But red tape and risk management also hold some advantages. Syed F. Zaidi, MD, whose group is pursuing a divisional merger with other radiology groups (an arrangement in which practices agree to share the costs of certain services, such as imaging and transcription, but maintain autonomy in other key actions, such as marketing), says that becoming a larger group can help cut certain expenses, such as overhead and malpractice insurance costs. Staffing costs can also change. If you're becoming a larger practice, you may be able to consolidate your business management or office staff. And becoming part of a hospital means that you likely won't pay these costs at all. Breslau adds, "We now have access to the full range of specialized back office functions that you would expect from a multi-billion dollar system like Sutter Health, including HR, compliance, IT, legal support, and billing. The risk of not doing those things well over time will undoubtedly increase."

Culture Clash

The culture of your practice is also going to change. Are you merging with a practice that values speed whereas yours prefers to take more time to ensure quality? How do your ideals about work-life balance fit with those of the health system or practice you are coming into? Cynthia S. Sherry, MD, FACR, observed this friction when her practice merged with another to become Radiology Associates of North Texas several years ago. When practices merge or consolidate, there will initially be a cultural clash, she notes. For example, quality and service may mean different things to different groups, so it's important to be sure everyone is on the same page, Sherry says.

Radiologists may also have to address the shift from a small group to a large one. Sherry notes that employees and leadership in small groups are often accustomed to having a loud and clear voice on how the group is run. She adds, "In a large group or a hospital, the needs or wants of each individual can no longer always be met — or sometimes even considered."

A merger may also bring a shift in the leadership structure of the group. For Breslau, that meant going from the president of RAS to an employee of Sutter Medical Group, and having several bosses. "I definitely went through the stages of grieving — complete with lying under the workstation in a fetal position," he jokes. "It's certainly different. But I needed to ensure that our 60 doctors and hundreds of employees had a secure future, and this was the way to do it."

And sometimes, notes Zaidi, a change in leadership can be a good thing. "It's understandable that you want to keep the same leadership," he says. "You have a voice, and there's stability in knowing that you have a say in your day-to-day practice and know exactly how decisions will turn out. But it's also worth considering that while your leadership may have had success with your older model of business, they may not be as successful in this new territory. A new, diverse group of voices may do better."

Helping Hands

The leadership of your practice may change, but it's possible to take the lead in other ways by helping facilitate change and make the adjustment easier for the rest of your practice. As you encounter issues, put them into perspective, suggests Breslau. Although he and his colleagues were concerned about the changes ahead, Breslau says that he considered what he believed to be the alternative: gradual unemployment. "We did a lot of scenario planning before moving forward and ultimately decided this was best for our interests. The planning helped change our perspectives and made things clearer for a lot of people," he notes.

It's also important that you communicate well, says Zaidi. Your staff may be concerned about job security or benefit changes, and leadership should be very clear about what is happening on those ends, says Sherry. Prioritize maintaining morale and get your human resources department involved in assuring stability. Some practices offer retention bonuses to keep valuable employees. And continue to reassure employees that you ultimately have their best interest in mind by doing what you can for those that might separate from the practice during your merger, Sherry says. Make sure they know you will act as a reference should they look for another position. You want to make everyone feel supported during what may be a challenging time.hh

Communicating well with the other group is important too. In the case of nebulous terms like quality and service, you should spell out what these things mean to your group up front, so that each practice can be clear about the other's goals before merging. And don't expect one perspective to necessarily win over the other; refusal to compromise could potentially cause a divide between your practice and the system with which you are merging.

Greater Good

Consolidation is a reality for many groups, but how the process goes is ultimately up to each member of the practice. "Allying with other groups is an opportunity and a risk," says Zaidi. "How well it goes depends on how your group reacts to it." Breslau adds, "No matter how difficult it is at first, remember that you all have the same goal. Your goal is to provide quality care for your patients, and working together will allow you to achieve it."

Growing Pains

For more information about practice changes, check out the ACR 2015 session "Mergers, Alliances, and Pressures Mandating Growth." Acquisition by a larger health system is not the only option; participants will learn the various affiliations their practices might pursue to protect and grow their business, as well as the benefits and pitfalls for those options.

By Meghan Edwards, copywriter for the

ACR Bulletin

Reprinted from the ACR Bulletin (April 2015, pages 16-18) and with express permission of ACR Press. Copyright 2015. American College of Radiology. All rights reserved.

The AAWR held its first teleconferenced book club on February 17. The inaugural book club, hosted by Dr. Julia Fielding and Dr. Lucy Spalluto, featured Sheryl Sandberg’s Lean In as the topic for initial discussion. Members from across the country and of various ranks, ranging from residents to department chairs, participated in this conference call event.

In her book, Sheryl Sandberg, COO of Facebook, offers a candid discussion of her pathway to becoming a powerful female executive while attempting to maintain her role as both a mother and a wife. Using several topics from Lean In as the foundation of the open forum, important topics such as “sitting at the table” or being present and visible in the workforce, staying engaged in your current position even when you feel that position may soon change, clarifying your goals for both yourself and those in your personal life, how to increase female presence within your department, and the ways in which female leadership can impact all women were covered.

This event served as a wonderful opportunity for many of us to share anecdotal stories from our past and to seek advice from others who have faced similar obstacles in career advancement. The importance of work-life balance and the many different ways each us have attempted to achieve this balance was discussed at length.

We hope this is the first of many AAWR book club events. Participants in the teleconferenced bookclub offered overwhelmingly positive feedback. This forum offers a truly unique opportunity to assemble the brightest and boldest advocates for women in radiology. As Sheryl Sandberg states, “Shared experience forms the basis of empathy and, in turn, can spark the institutional changes we need.”

*We welcome and look forward to suggestions for future book club topics.

Congratulations to the below members for being named the 25 Top Radiology Professors by MedicalTechnology-Schools.com

Want to praise a fellow AAWR member? Have an announcement to share? Send your " Kudos" to info@aawr.org, with the subject line " Kudos"

The Marie Sklodowska-Curie Award, is presented annually to an individual who has made an outstanding contribution to the advancement of women in radiology/radiation oncology. The nomination form will address the unique role the nominee has undertaken in leadership, clinical care, teaching, and/or scholarship and the accomplishments that impacted women in our professions. The nominee must be a long-term member of the AAWR. Presentation of the award will take place at the AAWR Annual Business Meeting Luncheon the Sunday during the RSNA Annual Meeting.

The Alice Ettinger Distinguished Achievement Award , recognizes the lifetime achievement and lasting contribution to radiology/radiation oncology and to the American Association for Women Radiologists. Candidates must be long-term members of the AAWR and must have distinguished careers as mentors, teachers, and leaders in radiology/radiation oncology, and public service.

The Lucy Frank Squire Distinguished ResidentAward in Diagnostic Radiology recognizes outstanding contributions in clinical care and scholarship. The nominees must be members of the AAWR and must be in residency training at the time of the award. Only one nomination per residency program is allowed. Nominees will be evaluated on the basis of outstanding contributions in clinical care, teaching, research, or public service.

To apply, the following information must be submitted in addition to completing the on-line application:

· a nominating letter from the residency director (to include a notation of what year the candidate will be in residency at the time of the award ceremony)

The Eleanor Montague Distinguished Resident Award in Radiation Oncology recognizes contributions to radiology or the AAWR, community involvement, service during residency, or research endeavors. Nominees must be members of the AAWR and must be in residency training at the time of the award. There should only be only one nomination per residency program. Nominees will be evaluated on the basis of outstanding contributions in clinical care, teaching, research, or public service.

To apply, the following information must be submitted in addition to completing the on-line application:
· a completed nomination form
· a nominating letter from the residency director (to include a notation of what year the candidate will be in residency at the time of the award ceremony)
· a letter of concurrence from the departmental chair; and
· a copy of the candidate's curriculum vitae.